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Organization
FOREST PARK HOSPITAL CORP #1
Active
Organization
FOREST PARK HOSPITAL CORP #1
Active
Other names
FAMILY MEDICINE OF ST LOUIS
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JERRIE K WEITH FHFMA (BUSINESS ADVISOR)
(618) 779-5508
Entity
Organization
Contact information
Practice address
6125 CLAYTON AVE, STE 222, SAINT LOUIS, MO 63139-3265
(314) 768-3685
(314) 768-3940
Mailing address
531 PEBBLE BROOK LN, HMAI, BELLEVILLE, IL 62221-7609
(618) 779-5508
(618) 206-8588
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/09/2006
Last updated
08/22/2020
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